6 Signs Your Baby May Have Tongue Tie

With the growth in interest, awareness and information about tongue tie, it is not surprising that some mothers may wonder if their breastfeeding concerns may be due to their baby having a tongue tie.

Here are 6 signs that may suggest you should consider having your baby’s tongue assessed:

Tongue Tie Sign #1: Painful Breastfeeding

A baby’s tongue function is very important for breastfeeding. When a baby attaches to the breast, her tongue is forward and down, cupping the breast and extending over her bottom gum. The baby moves her tongue to its lowest position to create a vacuum to remove the milk.

If a baby’s tongue movement is restricted (e.g. by a tongue tie), then the baby’s tongue function is impaired and this can result in a poor attachment to the breast which causes pain for the mother.

Of course, painful breasts or nipples can be due to a range of other factors such as poor positioning and attachment, nipple vasospasm, nipple thrush, engorgement, mastitis, blocked ducts etc. Seeing a lactation consultant or calling the Australian Breastfeeding Association can help you work out why breastfeeding is painful for you and what to do about it.

Tongue Tie Sign #2: Damaged Nipples

A baby has to attach well to the breast to help ensure breastfeeding is comfortable and to help ensure good milk removal. A baby is attached well to the breast if her:

Chin is in, touching the breast

Nose is free

Lips are not sucked in but curled outwards

She has more of the ‘chin-side’ of the areola in her mouth than the side adjacent to her nose

If a baby has a tongue tie, a baby cannot attach as deeply, resulting in a shallower attachment. A shallow attachment means that your nipple is more likely to get pinched between your baby’s hard palate and her tongue. If this happens over and over, nipple damage occurs.

Nipple damage does not necessarily mean your baby has a tongue tie. Breastfeeding is a learned skill for mothers and it can sometimes take a little while to get the hang of it.

Nipple pain is common in the early weeks and it can take a little while to get the positioning and attachment right. Seeing a lactation consultant or calling the Australian Breastfeeding Association can help provide tips about improving the positioning and attachment.

Tongue Tie Sign #3: Baby Loses Suction While Feeding

A baby’s tongue function is important to maintain suction when breastfeeding. If the baby’s tongue movement is restricted by a tongue tie, this could affect how well a baby is able to maintain suction and it could also mean that a baby tires more easily with feeds.

There can be other mouth abnormalities too such a cleft lip or palate that can affect how well a baby maintains suction at the breast too. There can be other reasons why a baby may come on and off the breast too such as due to a fast let-down reflex. Seeing a lactation consultant or calling the Australian Breastfeeding Association can help you work out why your baby might be slipping off the breast.

Tongue Tie Sign #4: Clicking Noise While Feeding

If a baby’s tongue isn’t functioning optimally (e.g. due to a tongue tie), it won’t be able to move in the normal way while breastfeeding. When a tongue isn’t moving as it is supposed to, a baby is more likely to make noises (such as clicking) while feeding.

It is important to note however that sometimes if a mother has a fast let-down reflex, this could result in a baby making clicking noises as their tongue tries to slow the flow down. And, some babies are just noisier feeders than others.

Seeing a lactation consultant or calling the Australian Breastfeeding Association can help you work out what your baby’s clicking noises may be due to.

Tongue Tie Sign #5: Low Weight Gain In Baby Over Time

However, if a baby has a tongue tie, it can affect her ability to remove milk from her mother’s breasts. If not enough milk is removed from a mother’s breasts, this can lower her supply and mean that her baby doesn’t get enough milk and so doesn’t put on enough weight.

Sometimes, this is only becomes apparent after the early weeks. This is because in the early weeks a mother typically makes more milk than what her baby needs. This ample supply early on can sometimes conceal a baby’s lack of ability to remove milk well. After the early weeks however, when a mother’s supply settles down, if a baby continues to not remove milk well, this can mean that a baby’s weight gains slow down.

There are other reasons why a baby may not gain enough weight over time too. For example if a baby is put on a feeding schedule, a new pregnancy, a mother has started a medication that can lower supply etc. Seeing a lactation consultant or calling the Australian Breastfeeding Association can help you work out what why your baby may not be putting on enough weight.

Tongue Tie Sign #6: Recurrent Blocked Ducts Or Mastitis

If a baby is not able to remove milk as well from her mother’s breast (e.g. due to a tongue tie) this can mean that the mother’s breasts are not drained as well. This can result in milk stasis which increases the risk of a mother getting a blocked duct or mastitis.

There are many other reasons why a mother might get recurrent blocked ducts or mastitis, such as an oversupply, missed feeds etc. So, it is important to speak see a lactation consultant or call the Australian Breastfeeding Association to help you work out why you might be getting recurrent blocked ducts or mastitis.

It’s advisable to have your baby assessed by a lactation consultant if you suspect or have concerns that your baby may have a tongue tie. They will do a thorough assessment, including putting their finger inside your baby’s mouth and taking a full history to assess if your baby’s tongue.

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Renee Kam IBCLCCONTRIBUTOR

Renee Kam is mother to Jessica and Lara, an International Board Certified Lactation Consultant (IBCLC), a physiotherapist, author of 'The Newborn Baby Manual' and an Australian Breastfeeding Association Counsellor. In her spare time, Renee enjoys spending time with family and friends, horse riding, running and reading.

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